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www.dimagine.com A person’s needs are best met by people whose needs are met. - Jean Clarke
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A person’s needs are best met by people whose needs are met.
- Jean Clarke
Every act of self-improvement can be a subtle act of aggression towards the self.
- Pema Chodron
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Insert the word “need” into all questions of “why?”
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David Pitonyak
Difficult behaviors result from unmet needs.
(the very presence of a difficult behaviors means
that something important that the person needs is missing)
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Ours is a social brain
Cacioppo, J. & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. New York: W.W. Norton & Company.
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Being left out hurts
The dorsal anterior cingulate cortex.
Eisenberger, N.M., Lieberman, M. and Williams, K. “Does rejection hurt? An fMRI study of social exclusion.” Science 302, no. 5643 (2003): 290-92. DeWall, C.N., MacDonald, G., Webster, G.D., Masten, C.L. Baumeister, R.F., Powell, C., Combs, D., Schurtz, D.R., Stillman, T.F., Tice, D.M., Eisenberger, N.. I. “Acetaminophen reduces social pain: Behavioral and neural evidence.” Psychological Science 2010 21:
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Two packs per day
Cacioppo, J. & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. New York: W.W. Norton & Company.
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Loneliness is the only real disability
Karen Edna Wallstein, Campbell Village U.S.A., Copake, NY, Photograph by Matthew Swarts,
New York Times Magazine, September 10, 2000
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-Beth Mount
the matching tool
www.dimagine.com Articles and Publications
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It’s not about coverage.
Karen Edna Wallstein, Campbell Village U.S.A., Copake, NY, Photograph by Matthew Swarts,
New York Times Magazine, September 10, 2000
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It’s about relationships
The man with a megaphone
Pitonyak, D. (2011) Upside down and inside out: Supporting a person in crisis. Available at Imagine web site: www.dimagine.com.
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Goldilocks…
Pitonyak, D. (2011) Upside down and inside out: Supporting a person in crisis. Available at Imagine web site: www.dimagine.com.
and the limbic brain.
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When you’re drowning, you don’t say ‘I would be incredibly pleased if someone would
have the foresight to notice me drowning and come help me,’ you just scream.
-John Lennon
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Supporting a Person with Post Traumatic Stress Disorder
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Anxiety changes us
Artist: Keanna C, Madison ,WI. Used with permission.
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Anxiety
Used with permission. “How anxiety affects performance.” The Merck Manual of Medical Information. (New York, 2003, p. 606)
The difference between the right amount and too much ‘aint much www.dimagine.com
An epidemic of falls
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Used with permission. “How anxiety affects performance.” The Merck Manual of Medical Information. (New York, 2003, p. 606)
When too much is too much Anxiety www.dimagine.com
It’s about self- confidence www.dimagine.com
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Butterscotch Disorder
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It’s about self-confidence
Growing in a pattern
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It’s about self-confidence
Knowing what to do
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It’s about self-confidence
Making a contribution
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It’s about self-confidence
Teaching coping skills
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Painting from Mental Health and Coping Facebook page: http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.borderlinecentral.com%2Freport1%2F&h=DAQFNPl0N
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It’s about self-confidence
Teaching coping skills
1. A ‘book’ of things the person loves. 1. Practice, lots of practice. 1. A list of things that tell you the
person is getting upset. 1. Practice, more practice.
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Painting from Mental Health and Coping Facebook page: http://www.facebook.com/l.php?u=http%3A%2F%2Fwww.borderlinecentral.com%2Freport1%2F&h=DAQFNPl0N
Imagine
David Pitonyak 3694 Mt Tabor Road Blacksburg, VA 24060 540-552-5629 [email protected] www.dimagine.com
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Upside Down and Inside Out: Supporting a Person in Crisis
www.dimagine.com Articles and Publications
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Jumping Into the Chaos of Things and
The Discovery Workbook
www.dimagine.com Articles and Publications
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Difficult behaviors result from unmet needs.
(the very presence of a difficult behavior means that something important that the person needs is missing)
www.dimagine.com
Insert the word “need” into all questions of “why?”
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Ask, “When was the last time things were good (at least better than now)?”
____________ Date things were last good
____________ Today’s date
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1) Was there a change in important
relationships? Did someone important leave? Did someone new arrive?
2) Was there a change in the person’s physical
health or sense of safety? Was the person diagnosed with a physical illness? Was there a change
in his/her sleeping pattern or eating pattern prior to the difficult time?
Ask, What happened next?”
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High pain tolerance”
A lot of experience with pain.
Fear of expressing opinion.
Delerium
Neuropathy (disease of the nerves)/many causes
Fist jammed in mouth/down throat
Gastroesophageal reflux
Eruption of teeth
Asthma
Rumination
Nausea
Biting side of hand/whole mouth
Sinus problems
Eustachian tube/ear problems
Eruption of wisdom teeth
Dental problems
Paresthesias/painful sensation (e.g., pins and needles) in the
hand
Biting thumb/objects with front teeth
Sinus problems
Ears/Eustachian tubes
Biting with back teeth
Dental
Otitis (ear)
Uneven seat
Hip pain
Genital discomfort
Rectal discomfort
Odd un-pleasurable masturbation
Prostatitis
Urinary tract infection
Candidal vagina
Pinworms
Repetition phenomena, PTSD
Common ‘problem’ behaviors and speculation about their causes Ruth Ryan, M.D., Fames Salenblatt, M.D., and Melodie Blackridge, M.D.
Ask, “When was the last time things were good (at least better than now)?”
____________ Date things were last good
____________ Today’s date
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1) Was there a change in important
relationships? Did someone important leave? Did someone new arrive?
2) Was there a change in the person’s physical
health or sense of safety? Was the person diagnosed with a physical illness? Was there a change
in his/her sleeping pattern or eating pattern prior to the difficult time?
3) Did joy leave the person’s life? Has the person stopped doing something that he or she loves?
Ask, What happened next?”
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Ask, What happened next?”
4) Has there been a fundamental change in the
person’s power and control?
Has there been a change in the person’s control over day-to-day events? Important choices?
5) Was there a change in the person’s capacity to
contribute to others? Has there been a change in the person’s status with friends and family or community?
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Ask, What happened next?”
6) Has the person lost important skills or do new circumstances require new skills? Has the person changed jobs or engaged in new activities? Does the person know what to do?
7) Has there been a change in the support needs
of the person’s supporters? Have there been any changes in the well-being (e.g., health issues) or availability (e.g., a parent caring for an aging parent) of the person’s supports? Do members of the team require new training? etc.
7 Questions
1) How can we help the person to broaden and
expand his/her relationships?
2) How can we help the person to achieve a
sense of safety and well-being?
3) How can we help the person to find more joy
in ordinary, everyday community places?
Adapted from: O’Brien, J. & Lyle-O’Brien, C. (1987). Framework for accomplishments. Litohonia, GA: Responsive Associates.
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7 Questions
4) How can we help the person to have a better sense of power and control in life?
5) How can we help the person to make a
contribution to others? 6) How can we help the person to learn valued
skills (e.g., ways to communicate and cope)?
7) How can we better support the person’s supporters?
Adapted from: O’Brien, J. & Lyle-O’Brien, C. (1987). Framework for accomplishments. Litohonia, GA: Responsive Associates.
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It’s about self-confidence… for the person’s supporters too. www.dimagine.com
Bob’s list
1. They help me to do the things I want to do.
2. They help me to do the things I have to do and don’t boss me.
3. They ask me what I want to do every day and let me make my own decisions.
4. They know I need time to myself sometimes and leave me alone.
5. They make funny jokes.
6. They keep their promises.
7. They tell me things are going to be OK.
When staff are helpful… www.dimagine.com
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Readings
Badenoch, B. (2008). Being a brain-wise therapist: A practical guide to interpersonal neurobiology. New York: W.W. Norton.
Brooks, D. (2011). The social animal: The hidden sources of love, character, and achievement. New York: Random House.
Cacioppo, J. & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. New York: W.W. Norton & Company.
Davidson, R.J. & Begley, S. (2012) The emotional life of your brain: How its unique patterns affect the way you think, feel, and live – and how you can change them. New York: Hudson Street Press.
Gonzales, L. (2003). Deep survival: Who lives, who dies, and why. True stories of miraculous endurance and sudden death. New York: W. W. Norton and Company.
Grandin, T. & Barron, S. (2005). Unwritten rules of social relationhships: Decoding social mysteries through the unique perspectives of autism. Arlinton, TX: Future Horizons, Inc.
Holmes, H. (2008). The well-dressed ape: A natural history of myself. New York: Random House. Lewis, M (2011) Memoirs of an addicted brain: A neuroscientist examines his former life on drugs. Philadelphia:
Perseus Books. Ramachandran, V.S. The tell-tale brain: A neuroscientist’s quest for what makes us human. New York; WW
Norton. Rock, D. (2009). Your brain at work: Strategies for overcoming distraction, regaining focus, and working smarter
all day. Harper Collins e-books. Sapolsky, R.M. (2004). Why zebras don’t get ulcers. New York: Holt Publishers. Scaer, R.C. (2007). The body bears the burden: Trauma, dissociation, and disease. New York: Routledge. Siegel, D.J. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. New York: W.W.
Norton. Turkle, S. (2011). Alone together: Why we expect more from technology and less from each other. New York: Basic
Books.
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